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The purpose of this paper is to review safeguarding adult reviews (SARs) pertaining to individuals with acquired brain injury (ABI) since 2014. This extended literature review also explores the lessons and recommendations from these reviews in relation to social work practice within the UK.

The literature review reported and discussed findings across reviews and then used a thematic analysis to synthesise the findings and recommendations from the SARs reviews.

This paper identified four main themes: a lack of awareness of the needs of those with ABI and their families and around the symptoms and nuances of brain injury, particularly executive impairment and mental capacity, among social workers; poor interdisciplinarity led to a lack of shared communication and decision-making with professionals with such knowledge; a poor understanding of aspects of the mental capacity legislation, particularly surrounding unwise decisions, led to inappropriate or absent mental capacity assessments; and a lack of professional curiosity led to a lack of action where intervention or assessment was required.

This review identifies significant shortcomings in social work practice, education and training within the UK with regards to ABI.

This paper provides recommendations to current social work practice and highlights the need for significant improvements in pre-qualification and post-qualification training and supervision of social workers.

To the best of the authors’ knowledge, while there have been extensive reviews conducted on SARs, this is the only review that has focused solely on ABI.

Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing support, and have significant experience of clients with impairments to decision making. The purpose of this paper is to explore the application of the Mental Capacity Act (MCA) and its guidance when applied to ABI survivors. This research aimed to: first, highlight potential conflicts or tensions that application of the MCA might pose, and second, identify approaches to mitigate the problems of the MCA and capacity assessments with ABI survivors. It is hoped that this will support improvements in the services offered.

Using a mixed method approach, 93 BICMs responded to an online questionnaire about decision making following ABI. Of these, 12 BICMs agreed to take part in a follow-up semi-structured telephone interview.

The data revealed four main themes: disagreements with other professionals, hidden disabilities, vulnerability in the community and implementation of the MCA and capacity assessments.

The findings highlight the need for changes to the way mental capacity assessments are conducted and the need for training for professionals in the hidden effects of ABI.

Limited research exists on potential limitations of the application of the MCA for individuals with an ABI. This paper provides much needed research on the difficulties surrounding mental capacity and ABI.

This paper aims to look at the growing need for ethical leaders, suggesting that a strata of society called “cultural creatives” may answer that need. It investigates how the cultural creatives can be attracted and nurtured in positions of leadership and puts forward tangible action points and suggestions to help organizations take practical actions.

The paper is an interpretative phenomenological analysis of four cultural creatives who are in positions of leadership.

The finding with the maximum impact for organizations perhaps is that they all left positions where they felt unsupported and undeveloped, rather than push their employer for that support. Participants were predictably people-oriented, although this meant different things for each person. Their styles of leadership varied, but all shared a desire to become role models and leave a legacy. Only one worked within the third sector, and all were quite pragmatic and motivated by money, something that seems to be different from the original research on this group.

The paper highlights five key indicators organizations must consider to attract and nurture cultural creatives: flexibility in leadership style, levels of autonomy, acting as mentors, appropriate financial rewards, and opportunities for authentic, self-determined work.

The cultural creatives are reportedly the third largest social strata in Western society, after the modernists and traditionalists. They are growing as a group, and this study looks at how they operate and feel about their workplace. It provides insights into what it is like to be a cultural creative.

This is the only known research on cultural creatives since the original research in the early 2000s.

Brain injury rehabilitation is often complicated or confounded by difficulties with engaging the injured party with the services and input required. Lack of awareness of cognitive and executive impairments is often implicated in this difficulty. Any technique or approach that enhances engagement may then support rehabilitation. The aim of this paper is to examine the current evidence base for the use of motivational interviewing (MI) as a method for increasing engagement by supporting the development of insight.

The paper is a literature review, taking as its basis Medley and Powell's conceptual review of MI and then examining the published evidence available.

Although attractive to practitioners in the field because the purpose of MI and the goals underpinning acquired brain injury (ABI) rehabilitation are co‐terminus, the theoretical and research findings to date that address the effective application of MI to ABI are inconclusive. The literature presently available suggests there is no conclusive evidence that MI is a more effective approach than any other, and that which is available makes little reference to the specific difficulties of an ABI population that may confound MI's application in this area.

There is currently no high standard of evidence to support the use of MI with people with ABI.

There are still very few papers written, or research undertaken, into the effectiveness of MI with people with a brain injury. Most of the work undertaken thus far is concerned with supporting behavioural change in this population when problematic alcohol or drug use is co‐morbid. This paper identifies some of the practical difficulties with the approach whilst recognizing the inherent value in its aims.

The paper provides an opportunity for practitioners who wrestle with the difficulty of engagement on a daily basis to reflect upon how present practice could be altered to increase the likelihood of supporting engagement.

In recent years, the clinical performance of named cardiac surgeons in England has been disclosed. This paper aims to explore the nature and impact of disclosure of clinical performance.

The paper draws on literature from across the social sciences to assess the impact of disclosure, as a form of transparency, in improving clinical performance. Specifically, it employs the “programme theory” of disclosure.

The “programme theory” of disclosure involves identification, naming, public sanction and recipient response. Named individual (consultant) surgeons have been identified through disclosure but this masks the contribution of the clinical team, including junior surgeons. Mortality is the prime performance measure but given low mortality rates, there are problems interpreting this measure. The naming of surgeons has been achieved through disclosure on web sites, developed between the health‐care regulator and the surgical profession itself. However, participation remains voluntary. The intention of disclosure is that interested parties (especially patients) will shun poorly performing surgeons. However, these parties' willingness and ability to exercise this sanction appears limited. Surgeons' responses are emergent but about a quarter of surgeons are not participating currently. Fears that surgeons would avoid high‐risk patients seem to have been unrealised. While disclosure may have a small effect on individual reputations, the surgical profession as a whole has embraced disclosure.

While the aim of disclosure has been to create a transparent medical system and to improve clinical performance, disclosure may have the opposite effect, concealing some performance issues and possibly strengthening professional autonomy. Disclosure therefore represents greater transparency in health‐care but it is uncertain whether it will improve performance in the ways that the policy intends.

The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services.

A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs.

ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change.

An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings.

–Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs.

An underlying principle of supply chain management is to establish control of the end‐to‐end process in order to create a seamless flow of goods. The basic idea is that variability is detrimental to performance as it causes cost in the form of stock‐outs, poor capacity utilisation, and costly buffers. This paper questions this approach and argues that in the light of increasing turbulence a different approach to supply chain management is needed.

The paper reports on the authors' work on a Supply Chain Volatility Index and shows how current supply chain practices may no longer fit the context most businesses now operate in – primarily because these practices were developed under assumptions of stability that no longer hold true. The paper illustrates the findings with case study evidence of firms that have had to adjust to various aspects of turbulence.

The paper is able to show that most current supply chain management models emanate from a period of relative stability, and second, that there is considerable evidence that we will experience increasing turbulence in the future. This calls into question whether current supply chain models that feature some dynamic flexibility, yet are built on the general premise of control, will be suitable to meet the challenge of increased turbulence.

It is argued that what is needed to master the era of turbulence is structural flexibility which builds flexible options into the design of supply chains. This marks a major departure from current thinking and will require revisiting the management accounting procedures that are used to evaluate different supply chain decisions. The paper presents guidelines on how to manage supply chains in the age of turbulence: by embracing volatility as an opportunity rather than viewing it as a risk, by understanding its nature and impact, and finally by shifting the exposure to risk by building hedges into the supply chain design.

The paper questions the fundamental premise upon which current supply chain models are built and proposes an alternative approach to build structural flexibility into supply chain decision making, which would create the level of adaptability needed to remain competitive in the face of turbulence.